Human Fibrinogen Patches Application Reduces Intra-Abdominal Infectious Complications in Pancreas Transplant with Enteric Drainage

Purpose The purpose of the study was to analyze the incidence of intra-abdominal infectious complications after the application of a fibrinogen sealant to the duodenojejunal anastomosis in simultaneous pancreas–kidney transplants (SPK) with enteric drainage. Methods Results of 68 SPKs with enteric d...

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Veröffentlicht in:World journal of surgery 2010-12, Vol.34 (12), p.2991-2996
Hauptverfasser: Padillo, J., Arjona-Sánchez, A., Ruiz-Rabelo, J., Regueiro, J. C., Canis, M., Rodriguez-Benot, A.
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Sprache:eng
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Zusammenfassung:Purpose The purpose of the study was to analyze the incidence of intra-abdominal infectious complications after the application of a fibrinogen sealant to the duodenojejunal anastomosis in simultaneous pancreas–kidney transplants (SPK) with enteric drainage. Methods Results of 68 SPKs with enteric drainage were prospectively assessed. A fibrinogen and thrombin sheet was applied to the duodenojejunal anastomosis in 34 patients, who were compared to a control group of 34 patients. The incidence and severity of intra-abdominal infectious complications and the 1-year patient and grafts survival were analyzed. Results Eighteen patients experienced intra-abdominal infectious complications. Grade 1a complications occurred in the study group, whereas surgery was required only in patients from the control group: complications grade 3a (15%) and complications grade 3b (18%) ( p  = 0.003 vs. study group, respectively). The overall rate of anastomotic leakage (complications grade 2b and 3b) was 10%, all of which occurred in the control group. The length of hospital stay was higher in the control group was 34.6 ± 11.3 days vs. 22.8 ± 11.1 days ( p  = 0.03). There were no significant differences in 1-year patient and graft survival between groups. Conclusions In our study, the application of fibrinogen and thrombin sheets was associated to a decrease in the number and severity of intra-abdominal infectious complications.
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-010-0774-z